In this issue of Heart, Bleiziffer et al present a
study evaluating the best method to predict
valve prosthesis–patient mismatch (VP–PM)
before aortic valve replacement. As they point
out, VP–PM remains a controversial issue, and the
use of different methods to identify VP–PM might
have contributed to the contradictory results
reported in previous studies. Their findings are
important from two standpoints: (1) they demonstrate
that not all methods are equally efficient in
this regard and that in fact some approaches that
purport to attain this objective are for all practical
purposes useless; (2) they further confirm that
when the right method is used, VP–PM can be
predicted and also largely prevented by using a
simple strategy at the time of operation.